• Archives of Plastic Surgery
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• v.36 no.5
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• pp.670-673
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• 2009

Purpose: Epidural abscesses and subdural empyemas after craniotomy are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage and dural reconstruction in these patients are challenging. Methods: A 28 - year - old female patient showed recurrent intracranial infection after craniotomy for evacuation of a arachnoid cyst and subdural hematoma. Despite prolonged systemic antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated WBC count, CSF leakage, low CSF glucose level, and purulent wound discharge. The authors removed the previously applied lyophilized dura and transferred free omental flap to reconstruct the dura, obliterate the cyst and cover the cerebral hemisphere in the craniotomy defect. Microvascular anastomosis was between gastroepiploic and superficial temporal vessels. Results: The postoperative course was uneventful and flap survival was excellent. The infection - resistant omental tissue allowed sufficient blood circulation and dead space control. The patient was discharged 1 month after surgery and wound discharge or recurrence was absent during 13 months of follow up periods. Conclusion: The use of vascularized free omentum proved useful in cases of intractable cranial wound infection and cerebrospinal fluid leakages.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.4
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• pp.415-425
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• 1999

$[K^+]_o$ can be increased under a variety of conditions including subarachnoid hemorrhage. The increase of $[K^+]_o$ in the range of $5{\sim}15$ mM may affect tensions of blood vessels and cause relaxation of agonist-induced precontracted vascular smooth muscle $(K^+-induced$ relaxation). In this study, effect of the increase in extracellular $K^+$ concentration on the agonist-induced contractions of various arteries including resistant arteries of rabbit was examined, using home-made Mulvany-type myograph. Extracellular $K^+$ was increased in three different ways; from initial 1 to 3 mM, from initial 3 to 6 mM, or from initial 6 to 12 mM. In superior mesenteric arteries, the relaxation induced by extracellular $K^+$ elevation from initial 6 to 12 mM was the most prominent among the relaxations induced by the elevations in three different ways. In cerebral arteries, the most prominent relaxation was produced by the elevation of extracellular $K^+$ from initial 1 to 3 mM and a slight relaxation was provoked by the elevation from initial 6 to 12 mM. In superior mesenteric arteries, $K^+-induced$ relaxation by the elevation from initial 6 to 12 mM was blocked by $Ba^{2+}\;(30\;{\mu}M)$ and the relaxation by the elevation from 1 to 3 mM or from 3 to 6 mM was not blocked by $Ba^{2+}.$ In cerebral arteries, however, $K^+-induced$ relaxation by the elevation from initial 3 to 6 mM was blocked by $Ba^{2+},$ whereas the relaxation by the elevation from 1 to 3 mM was not blocked by $Ba^{2+}.$ Ouabain inhibited all of the relaxations induced by the extracellular $K^+$ elevations in three different ways. In cerebral arteries, when extracellular $K^+$ was increased to 14 mM with 2 or 3 mM increments, almost complete relaxation was induced at 1 or 3 mM of initial $K^+$ concentration and slight relaxation occurred at 6 mM. TEA did not inhibit $Ba^{2+}-sensitive$ relaxation at all and NMMA or endothelial removal did not inhibit $K^+-induced$ relaxation. Most conduit arteries such as aorta, carotid artery, and renal artery were not relaxed by the elevation of extracellular $K^+.$ Among conduit arteries, trunk of superior mesenteric artery and basilar artery were relaxed by the elevations of $[K^+]_o.$ These data suggest that $K^+-induced$ relaxation has two independent components, $Ba^{2+}-sensitive$ and $Ba^{2+}-insensitive$ one and there are different mechanisms for $K^+-induced$ relaxation in various arteries.

• Journal of Ginseng Research
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• v.46 no.4
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• pp.585-591
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• 2022

Background: Korean Red Ginseng (KRG) extract has been shown to have beneficial effects in patients with atherosclerosis, suggesting that KRG extract may be effective in preventing subsequent ischemic stroke in patients with severe atherosclerosis. Methods: This double-blind, placebo-controlled trial randomized patients with severe atherosclerosis in major intracranial arteries or extracranial carotid artery, to ginseng group and placebo group. They were given two 500-mg KRG tablets or identical placebo tablets twice daily for 12 months according to randomization. The primary endpoint was the composite of cerebral ischemic stroke and transient ischemic attack during 12 months after randomization. The secondary endpoints were change in volumetric blood flow of the intracranial vessels and the incidence of newly developed asymptomatic ischemic lesions. Any adverse events were monitored. Results: Fifty-eight patients were randomized from June 2016 to June 2017, 29 to ginseng and 29 to placebo, and 52 (28 and 24, respectively) completed the study. One patient in the placebo group, but none in the ginseng group, experienced ischemic symptoms (p = 0.46). Changes in volumetric blood flow and the presence of ischemic brain lesions did not differ significantly in the two groups, and none of these patients experienced adverse drug reactions. Conclusion: Ginseng was well tolerated by patients with severe atherosclerosis, with these patients showing good compliance with ginseng dosing. Ginseng did not show significant effects compared with placebo, although none of the ginseng-treated patients experienced ischemic events. Long-term studies in larger patient populations are required to test the effect of ginseng.

• Journal of radiological science and technology
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• v.46 no.1
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• pp.9-14
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• 2023

When measuring cerebrovascular with 3D rotational angiography, the accuracy was verified by comparing the actual size and measurement size, respectively. It is intended to help select therapeutic materials and instruments during cerebrovascular intervention by comparing the average error rates for measured values in the 3DRA and CTA methods by examining with protocols such as brain CTA, which are always performed in emergency situations. The mean error rate between the groups of measurers was ±3.655% for radiation technologist and ±3.331% for university students, and the mean error rate of the student group was within tolerance (±10%), and the independent sample T-test result t =0.879, p=0.394 (p>0.05) showed no statistically difference between the two. In addition, the average error rate measured by both groups by 3DRA was measured below ±5% within the tolerance error rate (±10%), and most of CTA was measured within the tolerance range (±10%), but showed an average error rate of up to 5.65%, and the independent sample T-test result was statistically more accurate than 3DRA. Both the 3DRA method and the brain CTA method for measuring cerebrovascular size could be accurately measured within tolerance, but it would be better to measure cerebrovascular blood vessels using a more accurate 3DRA method during cerebrovascular intervention.

• The Korea Journal of Herbology
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• v.22 no.4
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• pp.253-260
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• 2007

Objectives : Intracerebral hemorrhage (ICH) is characterized by breakdown of blood vessels within the brain parenchyma. Fundamental therapeutic strategies for ICH, particularly those aimed at neuroprotection, have to be established. So in this experiment, the effects of Woowhangchongshim-won, a traditional prescription formula for treating Cerebral Apoplexy in Asian countries, were investigated. Methods : After intraperitoneal injection of chloralhydrate, rats were placed in a stereotaxic frame. ICH was induced by injection of 1 U collagenase type IV and drug was administered orally for 10 days. The molecular profile of cerebral hemorrhage in rat brain tissue was measured using micro array technique to identify up- or down- regulated genes in brain tissue. These genes induced by brain damage were mainly concerned with general metabolic process such as primary metabolic process, cellular metabolic process, macromolecule metabolic process, and biosynthetic process. Results : The number of genes increased in control and not-changed in experiment was 374, and decreased in control and not-changed in experiment was 527. We are concerned with genes that can be recovered by treatment with medicine, it is especially interesting to above types of genes. Conclusions : Upon medicine treatment to the rat having cerebral hemorrhage, expressions of some genes were restored to normal level. Further analysis using protein interaction database identified some key molecules that can be used for elucidation of therapeutical mechanism of medicine in future.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.637-645
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• 2017

The objective of this study was to find the optimum test device for the cerebral blood vessels by comparing and analyzing the SNR and CNR methods for images of three devices (i.e., MRA, CTA, and DSA). The study targeted 90 patients who underwent cerebral angiography from November 2016 to May 2017. The measuring parts were measured by using Rt MCA, Lt MCA, and ACA Image J. The results of quantitative analysis showed that the mean SNR of MRA, the CNR of MRA, the signal strength of MRA, the mean SNR of CTA, the CNR of CTA, the signal strength of CTA, the SNR of DSA, the CNR of DSA, and the signal strength of DSA were evaluated as 254.87, 178.13, 326.81, 74.75, 62.2, 356.66, 26.85, 25.89, and 4400.69, respectively (p<0.05). As a result, both SNR and CNR methods measured it in the order of MRA>CTA>DSA. Statistical significance was determined by using ANOVA analysis at p<0.05 and Bonferroni method was used as a post-hoc analysis SPSS. In conclusion, the results of this study revealed that the optimum imaging devices were MRA, CTA, and DSA after evaluating randomly selected patients with cerebrovascular disease.

• Journal of Life Science
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• v.14 no.6 s.67
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• pp.975-985
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• 2004

This study attempts to investigate the developmental alterations of rat cerebral cortex, and the effects of EGEE on the developmental cerebral cortex in the prenatal, postnatal and adults were examined by morphological methods and H-E staining was used for the histological changes. In the case of injection of EGEE, at 14 day of fetal phase, parietal cortex was thickest $(95{\pm}12.7\;{\mu}m)$ but, it was thinner than in the control group $(102{\pm}14.0\;{\mu}m)$ and, occipital cortex $(57{\pm}10.5\;{\mu}m)$ compared with other cortexes was the thinnest in fetal phase. In the suckling phase, each cortex grew thick quickly but, after weanning phase, the growth of the cortex slowed and the thickness of cortex was similar to that of cortex in the adult phase. At 105 day after birth, the parietal cortex was thickest $(934{\pm}21.6\;{\mu}m)$ but, decreased compared with control group $(1113{\pm}19.0\;{\mu}m)$. When EGEE was injected in intraperitoneal of rat, the number of neuroblasts per unit area was largest $(207.7{\pm}11.4/10^{-2}\;mm$ at the mantle layer of parietal cortex at 14 day of fetal phase but, decreased compared with control group $(224.2{\pm}13.8/10^{-2}\;mm$ , and the size was largest $(7.5{\pm}1.3\;{\mu}m)$ at the ependymal cell layer of occipital cortex at 3 day after birth but, decreased compared with control group $(9.0{\pm}1.2\;{\mu}m)$. Simillar to control group, the number of granular cells and pyramidal cells were largest at the II and III layer of parietal cortex, but decreased during developmental phase. The size was largest at the IV and V layer of occipital cortex but it was decreased compared with control group. When EGEE was injected in intraperitoneal of rat, the cerebral cortex from fetal phase to 3 day after birth has differentiated into the 3 layers; ependymal, mantle and marginal layer, but empty cisternaes or vacoules in the cerebral cortexes and the condensed phases of neuroblasts were appeared. From 5 day after birth, it has differentiated into the 4 layers; molecular, external granular, mixed layer of internal granular, external and internal pyramidal cells and multiformal layer but, empty cisternaes or vacoules in the granular and pyramidal cell layers were appeared and the number per unit area of neuron was decreased. In the cerebral cortex of the weaning and adult phases, division of cell layers was not clear and empty cisternae was formed in the cortex with the cells in external granular and pyramidal cell layers, was magnified or condensed around blood vessels of neurons.

• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.94-100
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• 2005

Purpose : This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. Materials and Methods : Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. Results : A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3T-TOF MR angiography, TCD, and CA was high. Conclusion : 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.105-108
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• 2015

Background: The most definitive diagnosis of neck pain caused by facet joints can be obtained through cervical medial branch blocks (CMBBs). However, intravascular injections need to be carefully monitored, as they can increase the risk of false-negative blocks when diagnosing cervical facet joint syndrome. In addition, intravascular injections can cause neurologic deficits such as spinal infarction or cerebral infarction. Digital subtraction angiography (DSA) is a radiological technique that can be used to clearly visualize the blood vessels from surrounding bones or dense soft tissues. The purpose of this study was to compare the rate of detection of intravascular injections during CMBBs using DSA and static images obtained through conventional fluoroscopy. Methods: Seventy-two patients were included, and a total of 178 CMBBs were performed. The respective incidences of intravascular injections during CMBBs using DSA and static images from conventional fluoroscopy were measured. Results: A total of 178 CMBBs were performed on 72 patients. All cases of intravascular injections evidenced by the static images were detected by the DSAs. The detection rate of intravascular injections was higher from DSA images than from static images (10.7% vs. 1.7%, P < 0.001). Conclusions: According to these findings, the use of DSA can improve the detection rate of intravascular injections during CMBBs. The use of DSA may therefore lead to an increase in the diagnostic and therapeutic value of CMBBs. In addition, it can decrease the incidence of potential side effects during CMBBs.

• Journal of the Korean Institute of Telematics and Electronics
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• v.20 no.1
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• pp.63-71
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• 1983

A dye-edge tracking algorithm was used to determine the corresponding points in the two images(anterior-posterior and lateral) of the digital subtraction biplane angiography. This correspondence was used to reconstruct three dimensional images of cerebral artery in a dog experiment. The method was tested by comparing the measured image of oblique view with the computed reconstructed image. For the present study, we have developed three new algorithms. The first algorithm is to determine the corresponding dye-edge points using the fact the dye density at the moving edge avows the same changing pattern in the two projection views. This moving pattern of dye-edge density is computed using a matching method of cross-correlation for the two sequential frames' dye density. The second algorithm is for simplified perspective transformation, and the third one is to identify the specific corresponding points on the small vessels. The present method can be applied to compute the blood velocity using the dye-edge displacement and the three- dimensional distance data.